Individual
ELIZABETH A. SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
775 PARK AVE, HUNTINGTON, NY 11743-3976
(631) 659-4050
(631) 659-4099
Mailing address
775 PARK AVE, HUNTINGTON, NY 11743-3976
(631) 659-4050
(631) 659-4099
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
178990-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01464039
—
NY
01
—
0400986
GHI
NY
01
—
2C4865
HEALTHNET
NY
01
—
92K881
BLUE CROSS/ BLUE SHIELD
NY
01
—
CS493
OXFORD
NY
Enumeration date
08/08/2006
Last updated
09/29/2014
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